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NPI Code Detail

MEDICARE: JESSICA STRICKLAND DPT

MEDICARE:   JESSICA  STRICKLAND  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT 30514FL

General Provider Information

NPI Number : 1902281579
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA STRICKLAND DPT
Provider Business Mailing Address
First Line : 3533 CAROLWOOD LN
Second Line :
City : SAINT AUGUSTINE
State : FL
Zip : 32086-4320
Country : US
Telephone Number : 904-315-8525
Fax Number :
Provider Business Practice Location Address
First Line : 3533 CAROLWOOD LN
Second Line :
City : SAINT AUGUSTINE
State : FL
Zip : 32086-4320
Country : US
Telephone Number : 904-315-8525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2015
Last Update Date : 07/24/2015

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